SynthesisFrontiers in medicine2026
Prognostic value of interim post-treatment SPECT/CT following lutetium-177 (177Lu)-PSMA therapy in patients with metastatic castration-resistant prostate cancer: a systematic review and meta-analysis.
Synthesis in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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11 authors.
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Abstract
Background: Lutetium-177 (177Lu)-PSMA radioligand therapy (RLT) is established for metastatic castration-resistant prostate cancer (mCRPC), but radiologic monitoring during the treatment lacks standardization. While interim PSMA PET/CT offers accuracy, post-treatment 177Lu-PSMA SPECT/CT provides practical advantages for early response assessment. This systematic review and meta-analysis evaluates the prognostic value of interim post-treatment SPECT/CT parameters on survival outcomes in mCRPC patients. Methods: Following PRISMA guidelines and PICO framework, PubMed/MEDLINE, Scopus, and Google Scholar were searched up to December 2025 for studies on mCRPC patients receiving 177Lu-PSMA RLT with early post-treatment SPECT/CT. Inclusion required cohort designs reporting hazard ratios (HRs) for overall survival (OS) and PSA-progression-free survival (PSA-PFS). Data extraction included study characteristics, imaging protocols, and outcomes. Quality was assessed using the Oxford CEBM tool. Random-effects meta-analysis pooled HRs; heterogeneity ( Results: Seven studies (648 patients) were included. Pooled HRs showed emerging new lesions associated with worse OS (HR = 2.78, 95% CI: 1.91-4.06, Conclusion: Interim 177Lu-PSMA SPECT/CT offers prognostic insights, with new lesions and TTV increases signaling poor outcomes. Standardization and prospective validation are needed to integrate it into clinical practice.
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